What is a supracervical hysterectomy?
Elizabeth Howell, MD, is an obstetrician/gynecologist with McKee Center for Women’s Health.
Question: What can you tell me about supracervical hysterectomies?
Answer: A hysterectomy is the surgical removal of the uterus. It is one type of treatment for conditions such as heavy bleeding, large fibroids, endometriosis and uterine prolapse.
A hysterectomy may be performed through a variety of methods including open, transvaginal, laparoscopic and a robot-assisted laparoscopic method. A patient should discuss options with her physician to see which procedure is most appropriate.
A total hysterectomy includes the removal of the uterus and the cervix. When the ovaries and sometimes the fallopian tubes also are removed, the procedure is called a hysterectomy with a bilateral oophorectomy.
In a radical hysterectomy – most often done in cases of cancer — the surgeon removes the uterus, cervix, the top part of the vagina and much of the tissue around the cervix in the pelvis. The surgeon also may remove the pelvic lymph nodes.
Another option not often realized by many patients is a supracervical hysterectomy. In this procedure, the surgeon removes the uterus and leaves the cervix in place. The cervix links the uterus to the vagina and has two functions: It helps lubricate the vaginal area and provides support for a variety of pelvic ligaments.
Some surgeons recommend the removal of the cervix as a preventive measure against cervical cancer. If a woman does not have cancer or concerns with pre-cancer of the cervix, she may want to consider a supracervical hysterectomy. Some women say removal of the cervix diminishes sexual pleasure. Others have said removal causes increased bladder and bowel problems. Healing and recovery may take longer if the cervix is removed because that is an extension of the surgical procedure.
Women who choose to leave the cervix in place must still have Pap smears regularly for cervical cancer screening.
A robotic-assisted laparoscopic supracervical hysterectomy is a nice hysterectomy option as it retains the normal anatomy at the top part of the vagina. It is thought to improve the support of the vagina and might decrease the possibility for discomfort with the intercourse that can occur after vaginal surgery. There is a small risk for continued spotting at the time of normal menstrual cycle if the cervix is left in place.
I find that patients heal very well after this type of hysterectomy and are very pleased. It is an option that should always be discussed when considering a hysterectomy.